Longer Maintenance Therapy Duration May Improve Survival in Myeloma

A longer duration of lenalidomide maintenance therapy after autologous hematopoietic stem cell transplantation (HSCT) may improve progression-free and overall survival in patients with multiple myeloma, according to a study published in the journal Cancer.1

Although maintenance therapy with lenalidomide has demonstrated improved clinical outcomes following autologous HSCT among patients with multiple myeloma, the ideal duration of therapy remains unclear.

For the study, investigators analyzed data from 464 patients with multiple myeloma who were receiving lenalidomide after autologous HSCT between 2007 and 2013. Of those, 46% began therapy less than 4 months after autologous HSCT.

Results showed that median progression-free survival was 38 months and median overall survival was 78 months. Investigators found that lenalidomide treatment for greater than 2 years was associated with an 87% reduction in the risk of progression (hazard ratio [HR], 0.13; 95% CI, 0.04-0.38; P <.001) and a 91% decrease in the risk of death (P <.001) compared with those on maintenance therapy for 2 years or less.

Researchers further observed a trend toward improved progression-free survival (HR, 0.02; 95% CI, 0.00-0.44; P =.012) and overall survival (HR, 0.05; 95% CI, 0.00-0.83; P =.037) for patients treated for more than 3 years vs those on maintenance for 3 years or less.

There was no difference in survival between patients who initiated maintenance lenalidomide less than 4 months after autologous HSCT and those who began treatment 4 or more months afterward.

The study also demonstrated that the incidence of secondary primary malignancies among all patients was 3%.